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Passive Joking

Ever since I can remember, I’ve always had an unhealthy interest in punning. Whether it’s the titles of my blogs or everyday conversation, I can’t seem to resist getting in a pun wherever I can. (I also have a whole section on my CV dedicated to my ‘humorous’ articles including ones that feature nothing but puns). For the purposes of being clear as to what I am actually talking about, a pun – according to the Oxford English Dictionary – is a form of word play that suggests two (or in some cases more) meanings, by exploiting multiple meanings of words, or of similar-sounding words. Author and lexicographer Samuel Johnson went as far as to claim punning the lowest form of humour. In his book Jokes and Their Relation to the Unconscious, Sigmund Freud asserted that puns are “the lowest form of verbal joke, probably because they are the cheapest – can be made with the least trouble…[and] merely form a sub-species of the group which reaches its peak in the play upon words proper”.

There are a number of references to various forms of ‘compulsive punning’ in the psychological literature. One such name is that of 'Foerster’s syndrome'. This was coined by the Hungarian-British author and journalist Arthur Koestler (1905-1983) in a description of the compulsive punning first described by the German neurologist Otfrid Foerrter (1873-1941). Back in 1929, Dr Foerster was carrying out brain surgery on a fully conscious male patient who had a brain tumour. When Foerster began to manipulate the patient’s tumor, the patient began a manic outburst of telling one pun after another.

In 1929, a psychiatrist Dr. A.A. Brill reported what he believed were the first cases of Witzelsucht (“punning mania”) in the International Journal of Psychoanalysis. The word ‘Witzelsucht’ comes from the German words ‘witzeln’ (to make jokes or wisecracks), and ‘sucht’ (a yearning or addiction). This rare condition is characterized as a set of neurological symptoms resulting in an uncontrollable tendency to tell puns, inappropriate jokes, and/or pointless or irrelevant stories at inappropriate times. The patient nevertheless finds these utterances intensely amusing. Brill described some of the cases he had come across including a 31-year man with a brain tumour who made puns “about anything and everything”.

This observation by Dr. Brill is not unsurprising as the condition is most commonly seen in those people that have damaged the brain’s orbitofrontal cortex (situated in the frontal lobes of the brain) and often caused by brain trauma, stroke, or a tumour. It is this part of the brain that is most involved in the cognitive processing of decision-making. Old aged people are thought to be most prone to Witzelsucht because of the decreasing amount of grey matter. The condition is also listed in Dorland’s Illustrated Medical Dictionary, which defines Witzelsucht as “a mental condition characteristic of frontal lesions and marked by the making of poor jokes and puns…at which the patient himself is intensely amused”.

It has also been observed that those people with hypomanic disorders are also more prone to engage in excessive punning. During hypomanic epidodes, people’s speech is typically louder and more rapid than usual. Furthermore, it may be full of jokes, puns, plays on words, and irrelevancies. Others have noted that hypomanic episodes may comprise unexplained tearfulness alternating with excessive punning and jocularity. Neurologist Dr. Kenneth Heilman (University of Florida, USA) says he sees several cases of Witzelsucht each year. "One of the most dramatic cases (that I've seen) appeared to be attracted to my reflex hammer. After I checked his deep tendon reflexes and put my hammer down, he picked up the hammer and started to check my reflexes, while giggling". However, Dr. Heilman (as far as I am aware) has not published any of his findings or clinical observations.

A case study published by Dr. Mario Mendez in a 2005 issue of the Journal of Neuropsychiatry and Clinical Neuroscience claimed that Witzselsucht can occur in those with frontotemporal dementia (FTD). Over a period of two years and as dementia set in, a 57-year-old woman became the life and soul of parties, and would laugh, joke, and sing all the time. During medical examinations, she was highly talkative, animated, and disinhibited. Dr. Mendez reported that she was preoccupied with continuous silly laughter, excitement and frequent childish jokes and puns (i.e., Witzelsucht). Magnetic resonance imaging revealed major atrophy in the anterior temporal lobes of the brain. Citing previous (mostly old German) psychiatric literature, Mendez asserted that FTD is a disorder with a range of neuropsychiatric symptoms that can include Witzelsucht. This includes excessive and inappropriate facetiousness, jokes, and pranks. The woman was given a serotonin selective reuptake inhibitor (SSRI) and other psychoactive medications and her Witzelsucht subsided.

Also in 2005, Ying-Chu Chen and colleagues published a case report of Witzelsucht and hypersexuality after a stroke. The case involved a 56-year-old man who suffered a stroke. The stroke caused a facial palsy and dysphagia (i.e., difficulty in swallowing). Over the next few days, he became gradually more alert. By the fifth day following the stroke, the man became highly talkative. However, he started telling inappropriate jokes and witticisms, and became euphoric, prankish, and opinionated. He was concerned about his resulting functional deficits, but talked about them in a humorous fashion. Simultaneously with the punning, he also developed hypersexual tendencies, and used erotic words when women were nearby. He also harassed young nurses and other female caregivers. He was unable to correct his inappropriate behaviours. His relatives were very surprised at his inappropriate jokes and the hypersexual behaviours, which were different from that before he had the stroke.

Like the case mentioned previously, he was also given an SSRI as part of his treatment. The use of SSRIs produced a moderate reduction of the man’s aberrant behaviours. Although the physical consequences of the stroke improved, the man’s wife reported that his endless jokes were not only inappropriate in terms of context, but were often obscene. His medication was changed and he was given a noradrenaline reuptake inhibitor. Over the following two months, the inappropriate punning and hypersexual behaviors were rarely noticed.

Finally, (for no other reason than to leave you with a smile on your face), I thought I’d leave you with my top 10 favourite puns.